Causes of increased menstrual flow -Adenomyosis


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Adenomyosis is a medical condition responsible for the increased menstrual flow characterized with minimal abdominal pain. It happens when the inner lining of the uterus moved towards the outer lining leading to the thickening of the uterus. It is common among middle aged women with history of any uterine surgical procedure. It is also associated with fertility problem in some women.


Enlarged uterus
Abdominal pain
Heavy menstrual flow
Painful menstrual cycle
Increase in duration of menstrual period
Abdominal distention
Lower back pain
Painful and un-pleasurable sex
Nausea and vomiting


The exact cause of adenomyosis is unknown. Invasive tissue development, fetal developmental phase and use of stem cell use have been suggested to be responsible for adenomyosis.


The diagnosis can be done following physical examination of the patient with the aim of looking for a possible elevation of the wall. This can be followed with pelvic ultrasonography and transvaginal ultrasound usually used to diagnose symptoms like menorrhagia and dysmenorrheal.


Treatment Options
Available treatment options include any of the following:

Use of medication especially anti-inflammatory drugs in older patient nearing menopause to minimize the pains that may accomplished menstruation.

The use of hormonal therapy particularly estrogen and progestin can also be used to regulate pain as well as controlling bleeding.

Surgical procedure such as hysterectomy which is full removal of the uterus is another extreme management option especially in cases that is severe. It must be emphasized here that this option can severely impair the balance of hormone functions in the body, but if the benefit of removing the uterus completely outweigh its retention, it is better to allow for hysterectomy.

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Uterine artery embolization is another surgical management option for the condition. It is a minimal invasion of small particles to prevent the arteries from supplying blood blood to the cervix and the vagina. The non supply of blood to the cervix and the vagina help in shrinking adenomyosis. Embolization is widely accepted in the management of fibroid as it shrinks it.

MRI-guided Focused Ultrasound Surgery is a new, safer and successful procedure in the management of adenomytic. This process involves the ablation of the adenomytic tissue.

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